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Author
Topic: State Laws Are Contributing to the Spread of HIV and AIDS (Read 23961 times)

During discussion of another thread I had wondered what ever happened to the CDC recommendations that all persons between the age of 13 and 64 be routinely checked for HIV. No one seemed to know so I decided to figure out what the problem was and why this hadn't been fully implemented by now. As fate would have it a new article came out today which explains yet another bureaucratic mess in our country.

Here are the original guidelines which seem pretty thorough and intelligent. I didn't print the guidelines because they are lengthy and it would have distracted from my whole point, but here they are for reference:

ATLANTA (AP) - A new study says more than 30 states have laws that bar doctors from heeding a call by federal health officials to routinely test patients for the AIDS virus.

The Centers for Disease Control and Prevention announced new testing guidelines last year. It recommends all teens and adults under age 65 be tested for HIV when they visit doctor's offices, emergency rooms and other health care centers.

CDC officials say the guidelines are intended to make testing simpler by sparing primary care doctors from having to counsel patients before the test and getting patients' consent for it.

But the study released today in the online journal PloS One, finds that 33 states require informed consent for HIV tests, while 24 require disclosure of information about the testing and disease -- either in pretest counseling or in a consent process. It found only two states -- Rhode Island and Illinois -- took action to comply with the CDC recommendations.

I find it outrageous that people are not being screened for HIV and going untreated and undiagnosed for some bullshit "counseling" guidelines implemented by ass backwards and antiquated ideas.

Any standard consent form should allow physicians to test for HIV. Physicians are not required to go through rings and hoops to diagnose patients with cancer, multiple sclerosis, or any number of other diseases to my knowledge. This sounds like some fucked up result of do good-er idiots or the ACLU to me. I'm angry now that I got my answer as to what's going on.

I think a lot of it has to do with the stigma and the fact that there are few confidential tests available. The only ones I know of, in our area, are the $60 ones that you Fed. Ex. and get the results via code over the phone in three days. Getting a positive result from an HIV test is a traumatic enough experience without dealing with a lot else with it. I know I found my status with one of those tests. I wanted to hear it at home, in private, with my hubby there. I know there are problems with this, too, as some people benefit from counseling. That's why confidential tests should be available as an option to those who want them: let me deal with it at my pace as I'm ready. If I were newly infected, I might not want to get my HIV+ result from a general Dr. that happened to be ultra-conservative and judgmental of being gay, etc. Let people test in a situation where they feel comfortable and perhaps they'll be more likely to test.

I strongly disagree. In a context where people are not guaranteed healthcare and access to HIV medication, it is important that people understand the ramifications of their test result and so I think states that require special consent are right to do so. This is true for many illnesses but seems especially true for HIV: people with a positive test result will face serious difficulties acquiring healthcare. IF the government agreed to guarantee treatment to people with HIV, then I think streamlined testing makes sense. But in the present climate of private healthcare, where insurers are desperate to find ways to exclude people from coverage, I worry that HIV tests without consent would contribute to discrimination against people with HIV. Remember also that the federal government is tying Ryan White funding to 'names reporting' of positive test results to the CDC. So with quick testing and names reporting, we are talking about the government potentially building a list of all the HIV positive people in the US.

Does written consent °really° discourage people from getting a test done? Or are you suggesting that doctors test patients °without° even telling the patient that they are conducting the test? The later seems to me to be a very troubling proposition. So if the doctor is going to tell the patient anyway, does getting written consent °really° result in fewer HIV tests? I would actually be curious to know.

I really don't want to be inflammatory, but this issue really must be stated: Mandatory testing without having the resources for guaranteed follow-up and medical care is extremely dangerous. Testing without treatment is immoral. What good does it do to tell people they have HIV if they can't access treatment?

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"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

My point is that people are being misdiagnosed and going undiagnosed. No matter how you want to deal with all the paranoia about the stigma and the trauma it really isn't the point I'm trying to address. I think people are intelligent enough to understand they will need to seek out appropriate treatement.

Because of this system people are going untreated and undiagnosed and some are dying.

Now, tell me a cancer diagnosis or Parkinson's disease or any number of other diseases aren't "Traumatic"? This type of thinking is what I see a tunnel vision and I think it's important to address the bigger picture.

I've worked in a health care industry for 10 years. I can assure you that those medical records all of you think are so private are not. It's simply a myth.

Yeah, I agree that insurance companies are a problem and HIV is just one of many exclusions, but if you lie about your status they'll eventually catch it anyway and have an out so to me it's a moot point. I hate insurance companies and I know just how corrupt they are. Don't think I'm about to defend them.

However, do all of you really feel that we should segregate out a section of the population for specific guidelines like this? You've got to be kidding me. I guess protecting privacy outweighs saving a life?

I strongly disagree. If the actual number of HIV infected individuals was known in this country I think we'd have a better shot at getting better programs and improving existing ones.

there are many places ( states, cities, community centers etc, ) that conduct anonymous testing. Here in Texas ( Dallas) it is an easy thing to do and it is totally confidential.....you have to use your code number to get the results and if +tive they will provide counseling which consists mostly of how to get the attention and medications you may need..I don't subscribe to the "Govt collecting data on HIVers " conspiracy since they already collect so much about you anyway.....try getting some of that info.....If you have any insurance, private or public they already know you are +tive, if you get medicine from any pharmacy local or by mail they certainly know your status, when any Dr treats you for HIV virtually all states have a reporting requirement just as they do for most infectious diseases......In total I am not surprised that the CDC recommendations are not universally followed...This has always been treated as a "State" problem......and as the various pressure groups ( Ryan White etc...) gained influence the Federal govt became involved and chose to push the control and financing to the state level.....can't have it both ways.. ..

I agree that a test shouldn't be given unless proper treatment can be offered. And I know that a lot of people don't get treatment for one reason or another. If treatment can be guaranteed to be offered regardless of someone's financial means (and I mean that the right kind of treatment i.e. labs, medications, physicals etc.) then o.k. But if not, then don't intrude on someone's business when it comes to such a delicate nature.

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I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

I really don't want to be inflammatory, but this issue really must be stated: Mandatory testing without having the resources for guaranteed follow-up and medical care is extremely dangerous. Testing without treatment is immoral. What good does it do to tell people they have HIV if they can't access treatment?

Is there something wrong with doctors being required to counsel a person before taking an HIV test? The CDC also recommended that positive results should be given along with cholesterol levels, and other such tests. Ummmm.... yeah, something like that. I am glad these states require informed consent before such tests. People should make informed decisions, and the CDC is basically trying to take the ability to make an informed decision away. I understand this is a public health crisis, but people need to know what they are getting themselves into.

I especially take issue with the idea that pretest counseling isn't necessary.

The new guidelines was not for mandatory testing. The testing was to be offered to anyone that came in to a health care facillity, between those ages. No one was going to be forced to take an HIV test.

Is there something wrong with doctors being required to counsel a person before taking an HIV test? The CDC also recommended that positive results should be given along with cholesterol levels, and other such tests. Ummmm.... yeah, something like that. I am glad these states require informed consent before such tests. People should make informed decisions, and the CDC is basically trying to take the ability to make an informed decision away. I understand this is a public health crisis, but people need to know what they are getting themselves into.

I especially take issue with the idea that pretest counseling isn't necessary.

Look, I have nothing against counseling, but yes I think this is paramount to discrimination. Am I the only one who sees there are other diseases and viruses out there which require no "counseling"?

Seriously, I've read response after response all seemingly ignoring the fact that NO other disease or diagnosis require a battery of counseling or plethora of paperwork to get to the TRUTH?

I'm sorry I don't live in Denial Land and think that it's better people have the FACTS then die off because of some perceived issues.

How many people do all of you feel are acceptable DEATHS before we start tossing aside our self serving and selfish ideals are acceptable?

Do you think finding out you have HIV is just like finding out you have high cholesterol? How many other diseases carry such a stigma attached to them? Do people not want to date you or marry you or have sex with you when they find out you're diabetic? Do people with MS have difficulty telling their family that they have MS because they are afraid that their families might not let them eat off their plates anymore?It is everyone's personal choice whether or not they want to know. And if you get infected from someone who didn't know their status, then take some personal responsibility and realise you should have used a condom until you knew they were free from HIV.

Posted by: JamieD Do you think finding out you have HIV is just like finding out you have high cholesterol? How many other diseases carry such a stigma attached to them? Do people not want to date you or marry you or have sex with you when they find out you're diabetic? Do people with MS have difficulty telling their family that they have MS because they are afraid that their families might not let them eat off their plates anymore?It is everyone's personal choice whether or not they want to know. And if you get infected from someone who didn't know their status, then take some personal responsibility and realise you should have used a condom until you knew they were free from HIV.

Don't even try that kind of reasoning. No one was being forced to test, it ones option to test, but the health care facillities have to offer it to you if you fall within that age bracket. No one is being forced to do anything. Have you even read the guidelines?

Don't even try that kind of reasoning. No one was being forced to test, it ones option to test, but the health care facilities have to offer it to you if you fall within that age bracket. No one is being forced to do anything. Have you even read the guidelines?

I would like to thank Rod for bringing back a sense of rational to the subject at hand. Comparing cholesterol and HIV is ludicrous to me and I don't think this is even an adult argument to the situation at hand.

I've read all the guidelines and I've posted this as a group topic in my own group on Myspace and I was rather impressed by the response of a young gal who has indicated her thoughts on the topic so articulately.

Boy, I am starting to feel like the one admitted leper in the colony here. Let's try to refrain from attacking each other and I have a challenge for those out there who have actually bothered to read the guidelines and additional commentary. Please read it and absorb it prior to responding out of your own fear or what you may think of me personally.

I think this a very serious issue and it amazes me at the dramatic and negative responses I've read thus far.

I personally think the CDC guidelines will help save thousands if not millions of lives. I'm not one to sit here and argue over petty issues and conspiracy theory topics in great length.

The reality is that lives can be saved if people actually know there status. I don't care if you love me or hate me, but surely you many of you are able to put aside personal issues to look at the bigger picture.

Not one person has addressed the issues I've brought up about the multiple other critical and life threatening illnesses which people are faced with aside from HIV and why they either feel all of those require "counseling" or special handling. Why is that?

I think if we could bring this issue to the forefront in a sensible fashion without singling out certain people we might have a shot at making headway.

Finding out you have HIV is not like finding out you have high cholesterol, I’m in total agreement with that, but if you have extremely abnormal test results, that means your doctor should counsel you before more tests are done, especially when those results could be indicative of a life-changing diagnosis.

Perhaps if doctors were to explain thoroughly all the tests that would be performed routinely, including HIV, then patients would be better prepared when they get that call saying “Your test for__________ came back with_________” then patients would be better prepared for the confirmation tests that would be ordered.

In a hospital setting, whenever we want to change the way caregivers perform, we talk about the “culture” of the healthcare setting. If said culture included antibody tests in the doctors’ routine care, then maybe we could get antibody tests to be performed as accepted and expected as a regular part of checkups.

I remember going to see my new doctor in 1999, and telling him that I hadn’t really had a checkup in 10 years. He sent me off with a lab slip telling me that those were the routine tests for a man of my age and situation, and if there were any “out of range” results he would call me, whether blood sugar or CBC items or liver panel or a billion ketones. I don’t see why if every doctor did this, HIV couldn’t be accepted as a regular test, but it’s trying to integrate the culture that clashes with the existing stigma.

But I will say that my doctor at that time, whom I still like and respect but don’t see for insurance reasons, also gave me my positive results over the phone on the Friday afternoon before Memorial Day, and ended the call with, “so that’s where we are now.” I hated him for a few months. He was weird for awhile, and seemed uncomfortable, but he finally warmed up and acted normal. Plus he was kind enough to do the antibody test anonymously, so it wouldn’t go to my insurance, and then wrote off the charges when I tried to pay for the test.

Are we (as a culture, society, or whatever) willing and able financially to deal with all the new HIV+ people that will suddenly 'exist' and need some sort of help, whether counseling, financial assistance, etc? I agree that testing should become more routine, but stopping the spread of this virus doesn't end with a test result; it only begins there. I don't know what would or could stop the spread of HIV, but surely it'll have to be something medical, as in a vaccine or a 'cure'.

Are we (as a culture, society, or whatever) willing and able financially to deal with all the new HIV+ people that will suddenly 'exist' and need some sort of help, whether counseling, financial assistance, etc? I agree that testing should become more routine, but stopping the spread of this virus doesn't end with a test result; it only begins there. I don't know what would or could stop the spread of HIV, but surely it'll have to be something medical, as in a vaccine or a 'cure'.

Heya David,

I really appreciate the thought and various opinions you bring to any topic whether I agree or don't. You've a great knack for addressing all sides to a topic I think.

I'm not here to propose a cure or vaccine in this topic.

I'm merely bringing the subject upfront and hoping to learn. I have yet to hear from one single person who has actually read the information and subsequent discussion about the idea that YES, as a matter of truth and fact everyone who happens to test HIV+ has a VALID RIGHT to know their status without being tossed into some emotional trash compactor as if they have NO mind of their own. I find this concept to be not only demeaning, but rather patronizing in nature. I've mentioned a variety of life threatening illnesses and conditions which require nothing like this. I don't think all of us are such pathetic victims and quite frankly I a bit stunned by those who are so Hell bent on making sure we are all dragged down into the caverns of Hell with them. Rubish!

I think people are a LOT tougher than we are giving them credit for. Just for instance let's think about the HIV situation in the US. Currently, 1.2 million are presently known to be living with the virus here. There are some 6000 people represented here. Are all of you so fragile and suicidal?

Ok, Wesley, I'll take the bait! I'd demean or patronize any day to err on the side of caution. Just as you think people should be able to learn their status as routine (your blood pressure is 120/73, your LDL is xxxx, your HIV antibody test is positive, etc), I think that it's just as important that people be able to receive what help they need following such a test. This help can be in many forms, such as medical, counseling, education, etc. All 6000+- members on this forum have some form of internet access and a pc available somewhere. A lot of people don't. A friend of ours whose brother was homeless and a junkie (her term) didn't have this benefit. He was assisted in some fashion after diagnosis, but certainly didn't have anything like 'net access and this forum. If we're going to treat HIV like any other illness, we need to do so all the way. That means no more stigma or discrimination. I don't see how we can end either of these two things, but until we can, HIV will not be 'just another illness'. And yes, I did read the link in your initial post!

I haven't read every word of every post here, but one thing stands out that some have made reference to but have not elaborated.

The Problem you point out here in your original post has not been lost on many of us in this work fulltime. Yes, you are right, this is an abomination and goes exactly in the reverse of what is logical from our standpoint.

That being said; the CDC makes guideline projections/recommendations all the time, but if it is not a mandate which is funded, there are few hospitals and private physicians who will comply.......UNLESS........ it is easy, cheap and doesn't cut into the bottom line of the practice or health care facility. You see Wesley, unfortunately money, risk, increased work load, increased reporting, and on and on, are real and tangible issues that hospital boards as well as private doctors have to face daily. More and more, doctors are going for the easy buck and while many of us know that HIV is far different today than when they were in medical school, this disease has been left on the infectious disease department, and those doctors are far and few between these days. They are always in great demand, but seldom pay worth a shit, so they go to other specialities to bolster their incomes.

My hunch is that states have been hesitant to enforce these recommendations, as most of the time the responsiblity falls on the medical community without any compensation, but it then becomes an orphan child of the states, and in turn adds Millions of dollars to their health budgets, which are already bursting at the seams.

I am not saying here that these are the only reasons, but you did request that we bring all issues in this discussion to the table, so I just couldn't help myself. Sorry, I am a Capricorn.

Love,

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The Bible contains 6 admonishments to homosexuals,and 362 to heterosexuals.This doesn't mean that God doesn't love heterosexuals, It's just that they need more supervision.Lynn Lavne

Ok, Wesley, I'll take the bait! I'd demean or patronize any day to err on the side of caution. Just as you think people should be able to learn their status as routine (your blood pressure is 120/73, your LDL is xxxx, your HIV antibody test is positive, etc), I think that it's just as important that people be able to receive what help they need following such a test. This help can be in many forms, such as medical, counseling, education, etc. All 6000+- members on this forum have some form of internet access and a pc available somewhere. A lot of people don't. A friend of ours whose brother was homeless and a junkie (her term) didn't have this benefit. He was assisted in some fashion after diagnosis, but certainly didn't have anything like 'net access and this forum. If we're going to treat HIV like any other illness, we need to do so all the way. That means no more stigma or discrimination. I don't see how we can end either of these two things, but until we can, HIV will not be 'just another illness'. And yes, I did read the link in your initial post!

David

David, I think one thing you and I and most everyone can agree upon is that an HIV diag. is initially devastating. My point which apparently I shall have to REHASH over an over again it that putting things into perspective HIV is NOT the worst illness or disease in this county. Certainly, by personal experiences from friends and family I've dealt with a vast array of debilitating and horrific issues that range from cancer to Alzheimer's and others.

I have rehashed the question over and over again, but NOT one person seems to feel all of these other people faced with tragic and traumatic diagnoses needs all the RED TAPE BULLSHIT counseling and special "protection" by law. Am I just crazy or is this just a tad hypocritical?

Personally, I don't believe that the CDC guidelines will make some "utopia" society for all of us, but I don't think it will hurt. We've all been either living in a closet intentionally for the last 25 years and look where it's gotten us? People are so scared and in some instances rightfully so. I ask (not just you) do people think this is helping the cause?

It's all so ironic to me. I fight with my own parents who are conservative Republicans. Ugh, I may be sick now ; ) HELL, both of them are in their 70's and now seem to realize the tragic situation in our country for people with HIV and other illnesses. Despite their prior attitudes which apparently existed inside some box I've managed to break though to reality with them overall. It wasn't easy and I put out the effort and made a difference. Yeah, I still want to puke when my dad listens to Rush Limbaugh and I keep on fighting with my own family.

I wish I could be like some of these other people and just not care, but it's not in my nature. I don't think I can personally change the world, but I'll be damned if I'm just gona go along with the "politically correct" losers who apparently are part of the pod people who have no ability to think for themselves or even make the slightest attempt at improving things for others.

David, I like you. None of my rambling commentary is directed at you personally. I do however wonder how others can live with their own apathy and sit around doing nothing?

OK, if the doctor (or nurse) asks someone if they want to be tested, and that person says yes, has an HIV antibody test run and it comes back positive, then the hospital should be able to deal with everything the person who got tested wants, i.e. "what kind of treatment can I get, I don't have any money," "where can I find a good doctor," "what do I do now." So if they want that, then they should invest on schooling their workers on all the counseling techniques/referral sources etc. that would go along with it.

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I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Betty, at Ohio State Medicial Center, they did everything for me. They set up my ADAP, they filed for my SSI and sent the paperwork to Jobs and Family Services for medicaid. I guess it depends on where you go, how much help you get.

1. While I do agree that support and treatment SHOULD be available to all who get a positive test, I do NOT think that the lack of such support means people shouldn't know their status. Denial does not make the virus less dangerous or less able to be passed on.

2. The issue of whether people should have counseling before a test is a difficult one and arguments can be made on either side. Counseling after a positive test is, I hope, a no-brainer.

3. Now, to the heart of the thread -- do the state laws contribute to the spread?? I'm not totally convinced. All the law does is require a discussion and SIGNED consent vs. verbal consent to take a test. So every doctor in every state can follow the guidelines by OFFERING the test. Do they? Probably some do and some don't. The real problem is likely to be that many, many DO NOT WANT TO BE TESTED. It can be offered every day, but if the patient says, "no", then it makes no difference. How many here avoided being tested for a period of time? I know that I did.

So, I think that offering the test is the real key here. The difference between signed vs. verbal consent is not a huge difference. I think that many of the laws were put on the books to insure that no one was tested without their consent. I know that many people go to their doctor and then go to the lab without knowing what they are being tested for or why. This is not a good thing, but it is reality. The written consent laws address this concern.

I find it outrageous that people are not being screened for HIV and going untreated and undiagnosed for some bullshit "counseling" guidelines implemented by ass backwards and antiquated ideas.

I find it sad that in this day and age there is an antiquated (and terribly off the mark) argument against mental health counseling for HIV testing and diagnosis.

Austin - your entire argument based off your subject line is flawed because of this particular point. It is not people not knowing their status that is the cause of the spread of the virus sexually - it is people not using condoms that is the cause of the virus being spread sexually.

I'm certain you must realize that someone getting a diagnosis of being neg today is not conclusive of whether of not they are neg at the time of the test results and has nothing to do with their status at the time of the test results if they engaged in any risky behaviour since testing.

I do hope you are able to comprehend and appreciate that vital point.

I assume you are able to, so now I ask: what good is having a neg result do for those who continue to not use condoms?

See that is the real issue.

We continue to see on this board how many people become embolden to continue having unsafe sex simply because they got a neg result...and yet as we all know a neg result doesn't necessarily mean one is neg, now does it?

So to your statement that State Laws are contributing to the Spread of AIDS because of counseling requirements - I ask:

Would you not agree that implicit in telling people that they have a neg result is counseling them and educating them on what the result means and what it doesn't mean and how to avoid risking themselves or others?

Frankly it comes down to one simple point (in relation to your argument:)

Is the government's responsibility towards the welfare of their citizens only to tell them they are infected at the moment of the test results or is it to offer them understanding of what the test results mean and how they can avoid infecting others and themselves and to try to make certain that it's citizens do not infect each other whether through willful neglect of information or blind ignorance of what the information means?

Not only do I believe it is the latter, but frankly anything less that seems more akin to your argument that the state governments might be a contributing factor in the spread of HIV.

Wow, this thread got so long I had to stop reading. (ADHD) Anyway, I dont know if anyone brought this up. But what about if the test everyone as the CDC recommends and the person chooses to know or not. Just so that we have a more correct count in the country of the people with HIV so that maybe when we get a new President they will spend some money on this issue. This may give the counseling that we need so that more and more will know their status and get the treatment they need and help stop the spread of this damn virus. It may also trigger the administration to finaly force the drug companies to spend more money on finding a cure rather than spending money on keeping us alive with drugs that they make billions off of. Just a thought.

My point which apparently I shall have to REHASH over an over again it that putting things into perspective HIV is NOT the worst illness or disease in this county. Certainly, by personal experiences from friends and family I've dealt with a vast array of debilitating and horrific issues that range from cancer to Alzheimer's and others.

Something about this line, this point that you have indeed rehashed numerous times on here just sticks in my craw. Something about having the seriousness is this illness dismissed time and again on its very own support site leaves me really cold. I'd love to see printed here your ranking for which diseases really qualify to be listed among the worst. I'm sure some others, like Christine perhaps, might like to see that as well. Imagine her embarassment when she realizes she's been making such a fuss over nothing.

Concern regarding reporting of names is not necessarily conspiratorial. You can't be known to have HIV if you never have a test. But what is happening is a proposed simultaneous increase in testing plus mandatory surveillance. I don't necessarily think it all amounts to a government plot that we should be super afraid of. Nevertheless, it's worth being critical about these developments and considering them carefully, rather than yelling about the ACLU – a red herring if ever there was one.

The point is that a conjunction of factors could yield greater surveillance and diminished freedoms through HIV, because in the US people live in a climate where people are not guaranteed care and where transmission can be criminalized in complicated and non-obvious ways (cf. California court decisions on 'constructive' vs. 'active' knowledge of HIV status).

For every person that eventually starts treatment six more people become infected. Sorry but the system can't bear it. The majority of funds for counseling and treatment come from public funds and the reality is that those funds are finite. The reality is waiting lists and overburdened bureaucracy's. We can wax esoteric all we want, but the reality of a six to one ratio in dealing with treatment versus rate of infections just does not seem sustainable.

Iggy is spot on in his assessment, though I would like to throw needle exchange in with using condoms.

Iggy is spot on in his assessment, though I would like to throw needle exchange in with using condoms.

I'm glad you brought that up and was meaning to add that to the previous post I made mentioning a friend's brother. He was one that possibly would have benefited from such a program. I think this almost makes more sense, in a way, than free condoms. Condoms are available almost everywhere there's a store. Needles and syringes aren't as easy to come by.

Moffie, when I first read this thread, when there were no responses, I started to post something related to the funding but figured I would be seen as putting money before what needs to be done. However you are totally right.

Testing everyone is simply not possible. The strain on the medical system, as auntie said, is just not sustainable. As an example I will offer my experience in finding a new doctor. In Louisville there are very few drs that specialize in the treatment of HIV. Recently my dr, one of said drs, closed his practice. Sending several hundred patients on a new dr hunt. When I had my first appointment with my dr, he said he was unsure how all of us would be able to find a new HIV dr, as he was being stretched with all the new cases.. We are fortunate and have insurance. Imagine what will happen when 100's turn into thousands, many without insurance, find out they are HIV+.

I agree everyone who is positive needs to know. However just testing and telling someone they are HIV+ simply is not enough. It gives the appearance (like so many other problems our government tries to fix) that something is being done to prevent the spread of HIV, but without medical treatment, including the opportunity for mental health treatment, what good does it do. We must figure out how to take care of all the new cases that will exist before implementing a policy of universal testing.

BTW, spot on Iggy.

Woods

edited for clarification

« Last Edit: October 11, 2007, 10:48:41 AM by woodshere »

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

Here's one reply from a gal in my group who's responded from a different perspective from someone who does HIV testing I found interesting:

"It is a mess. I work in the testing field in Pennsylvania. Not only is there a consent that needs signed, but a history form (which is completely different then the "regular" history form for general STD testing) and then on top of that there is a risk assessment form. By the time I actually see the patient they have been in the office for at least 30 minutes filling out papers. If I could just order the test for everyone that walks in the door - it would be so helpful for everyone. I feel that it would also release the stigma of going to get an HIV test - because now everyone gets one."

I happen to agree with her. Surely, I'm not the only one who knows several people who ended up in the hospital sick from a whole variety of issues and didn't have a clue they were HIV+.

Had I not insisted on my own HIV test I'm not sure I would have ever known the truth because originally the symptoms I had from seroconversion were mistaken as a likely allergic reaction to a prescription drug I'd recently taken.

I've never tried to minimize the impact of HIV/AIDS. I'm trying to put it into perspective. I find it ironic that all of the other tragic illnesses out there don't require doctors and medical staff to go through reams of paperwork, red tape and counseling to get to a diagnosis.

I wonder how many people going misdiagnosed or undiagnosed are continuing to spread HIV unwittingly to their partners?

I'm not saying the states are responsible, but it certainly seems to me that these stupid laws are contributing to the epidemic and even the stigma as I see it.

isnt one of the main reasons mandatory testing for hiv is off limits because there was time when many feared this could be used against them? Even some feared all of us could be rounded up and sent off to Australia? I wish. The people who proposed this back in the day were attacked as being fascists and worse.

I do agree finding out you are hiv pos is more traumatic than discovering you have high cholesterol but approx.450000 died from heart disease last year in US. the most recent figure I could find on HIV was 2005,and the deaths were around 17000 with a total of 500000 infected.

As to the complexity and number of forms that need to be signed, I'll agree that the what the lady in Penn. deals with is a bit extreme to me. I believe that when I had a confirmation test done after my mail-in test, I just signed the one for being tested for HIV (but I can't swear to this). Doing it anonymously would / could eliminate lots of this BS and simplify things. Simplification can be good, as in less overhead, which should mean less cost.

I think a variety of testing options would be a good thing, though. The lab in the second installment of Stephen Fry's show is a good example of a simple testing situation. I can understand that once one needs medical or some sort of assistance things would get a bit more complex. But to actually get large numbers of people to test, it has to be easy. It has to be unintimidating. It has to be private and discreet. It has to be tailored to serve the people needing the testing. People who go to a 15 minute testing center wouldn't have much in the way of counseling, but they'd be informed of that up front. They'd be told that they can have the test done elsewhere that has resources (assuming such a place exists) to assist them. In the event they test positive, they could be given information on where to go from there... in what steps they can take. All of this goes back to downplaying the stigma of an HIV diagnosis instead of emphasizing it, as the myriad of forms mentioned in Wesley's example would do.

If the actual number of HIV infected individuals was known in this country I think we'd have a better shot at getting better programs and improving existing ones.

Very good point.

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My point which apparently I shall have to REHASH over an over again it that putting things into perspective HIV is NOT the worst illness or disease in this county. Certainly, by personal experiences from friends and family I've dealt with a vast array of debilitating and horrific issues that range from cancer to Alzheimer's and others.

Something about this line, this point that you have indeed rehashed numerous times on here just sticks in my craw. Something about having the seriousness is this illness dismissed time and again on its very own support site leaves me really cold. I'd love to see printed here your ranking for which diseases really qualify to be listed among the worst. I'm sure some others, like Christine perhaps, might like to see that as well. Imagine her embarassment when she realizes she's been making such a fuss over nothing.

I don't see this as Wesley minimizing or dismissing HIV or advanced progression of the disease in any way. In terms of devestating effects, there are many many other afflictions that are equally tragic, life shattering, depending on varying stages of disease progression. I do see how it could be interpreted as such, as Thunter shared, though I don't seet it that way. I think he made a valid point.

Anyway my main point was my first statement.

Very interesting views and good food for tought. I have to say I go back and forth on this whole topic and haven't made upo my mind yet.

Peace!Mikey

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"You know you all are saying that this is incurable. When the real thing you should be saying is it's not curable at the present time' because as we know, the great strides we've made in medicine." - Elizabeth Edwards

Hi all I am new to this group but I have been reading and I must say there is a LOT of reading to do. I read some post and nearly laughed and others I sat here in horror to think and see that people could really think in such ways.

Points that shocked me;

I read in one post ( don't ask me wich one there are to many to go back through.) that people not knowing their HIV status is not the cause of the spred. You have got to be joking!!! you can not tell me that ignorance is not the problem. then some one suggest they get the test but choose not to get the results. ? What good does it do to have a wonderful number and thousands of people running around not knowing they are spreding HIV. I am thinking that kind of defeats the pupose of testing all together. It not about gathering numbers it's about people knowing if they have HIV or not.Now about condoms being used or Not being used. I think if more people knew they were HIV+ they would be using condoms. Again ignorance is not the solution here.

Now on the subject of HIV counseling. I really do know that pre testing counseling is all it is cracked up to be. Post testing conversation are not such a bad idea when the person feels they are ready to talk about it. Not every one is ready to be counseled as soon as they hear the news. for some they need time to let it set in and develope the questions they need to ask.

Now as for the guidelines as I understand this they are not Mandatory nor are they federal law that all people be tested for HIV So why are people bickering about it It's not even a point.

Should people be asked if they want to be tested. Of course they should. Should they be treated as if this test is any different than testing for Cancer or Tay-Sachs Disease or MS or Diabetes, NO. All of these can be fatal and all of them are life altering yet none of them require that people be counseled before or after testing. Why because they are accepted as common illnesses for ALL people. I agree with Wesley that required counseling for HIV testing is discrimination. To offer counseling is one thing but to force it is very much another. To offer medical assistance is the right thing to do. To referr people to other sources is also the right thing to do. WHEN they are ready for it.

If the actual number of HIV infected individuals was known in this country I think we'd have a better shot at getting better programs and improving existing ones.

I think this is a very good point.

Funding for care (of HIV or anything else) is a big issue, but am I actually seeing people advocate that folks should not find their status if they don't have the means for treatment? Do we really need to solve funding first? While that would be the PREFERRED way, it certainly isn't feasible, so should people wait until they are on death's door to find out their status? I don't think that is what is being said here, but there have been a number of posts that could be interpreted that way. Knowing has got to be better than not knowing -- even if treatment isn't available, some people might still be able to insure that they don't pass it on (yes, condoms should be used by neg or poz, but obviously this isn't happening).

Finally, I'll say it again -- doctor's always have the ability to offer an HIV test to a patient. If they aren't doing so because of "paperwork" or "red tape" then they need to hand in their licenses. If people refuse to have the test because of paperwork or red tape, then most probably would have found some other reason to avoid it anyway.

Interestingly, none of my doctors ever asked me if I wanted a HIV test -- and I've had about 5 or 6 different primary care docs over the years.

The unfortunate truth is that many people only get tested when they have a personal concern (like a risky experience) or they have physical symptoms (of illness.) I’m not saying most, I’m saying many. And this applies to HIV, cancer, diabetes, etc.

After thinking about it for a day, I’m definitely for routine testing. As an (mostly) STD, HIV is stigmatized, but look at where we are with herpes and HPV these days. Media and other exposure have made these mainstream, and we can access information that tells us “X number of Americans have __________.’ The same info is ours for the estimated X number of Americans with HIV, but HIV is still not considered mainstream.

Anyone, even rich white people, can get herpes or HPV. It’s just accepted. When will HIV be accepted the same way?

Testing is very important and would inform many who do not know. But millions of Americans don't go to the doctor. So are we going to have ER's and urgent treatment centers do the testing whenever someone comes in to their facility. Testing alone will not solve the problem, it has to be done with better education, also a greater willingness on an individual to protect themselves.

Plus until we decide where the money will come from for all the new cases, I am not convinced mandatory testing is the best at the present time.

Woods

edited because i posted before being finished

« Last Edit: October 12, 2007, 01:21:17 PM by woodshere »

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

I just want to clarify that I'm talking about routine testing, not mandatory testing. You go into the doctor's for a check up, you go into hospital to have a baby, you get tested. You go into the ER for a broken arm, they need to do an xray and treat your arm, not run a bunch of bloodwork. Likewise, if you have more serious trauma, they run the tests needed to stabilize you right then, and then as you are recovering they maybe do more routine stuff. This country is not ready for mandatory testing.

Will routine testing be able to reach some of the highest risk groups? I only ask because I fear that if routine testing begins the perception will be that now we are finally get a grasp on the number infected, when thousands still will not know their status because they don't go to the doctor.

« Last Edit: October 12, 2007, 01:43:20 PM by woodshere »

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"Let us give pubicity to HV/AIDS and not hide it..." "One of the things destroying people with AIDS is the stigma we attach to it." Nelson Mandela

Sure! If one would rather live in denial and neglect their health they have every right to. However, we all know people who didn't get diagnosed until they were extremely ill and that only adds to the enormity of health care costs in this country.

Many of us (including myself) support the idea of Universal healthcare for all. One way to help achieve this is with preventative medicine and early diagnosis whether it's HIV or any number of chronic illnesses.

I think we all need to share in some responsibility rather than contributing to the over taxing on the system because of self neglect.

Look at all the other things which have now become routine. Breast screening for women is one. Prostate and colon cancer screenings for men. I don't imagine those are necessarily enjoyable or comfortable events for anyone, but they save lives and money and increase awareness. My dad for instance is one of those who had such a screening and sure enough he had cancerous polyps. According to the doctor had he waited another 3 or 4 months the cancer would have metastasized and spread throughout his body. That's when people get really ill and it drives up the health care costs for everyone with lengthy hospital stays and related expenses that could have all been avoided.

Look at all the other things which have now become routine. Breast screening for women is one. Prostate and colon cancer screenings for me. I don't imagine those are necessarily enjoyable or comfortable events for anyone, but they save lives and money and increase awareness.

Unfortunately these tests are routine only for those that are insured or those wealthy enough to afford them.